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When medical research is outdated, it’s the patients who pay

Medical research can now be more person-focused than ever, writes Alex Irving, communications director at Patients Campaigning For Cures.

When Thomas Huxley and colleagues went head-to-head with Bishop Wilberforce in the ‘Great Debate’ of 1860, at the British Science Association annual meeting, it was a major nail in the coffin for creationism and triggered widespread public acceptance of Darwin’s theory of evolution.

Since then, the Theory of Evolution has itself evolved, and to such a degree that medical experts are calling for a second Great Debate, to settle an equally vital question for the scientific community – with seismic consequences for patients in need of effective treatments and cures.

Chronic diseases are rising rapidly. For example, cancer cases in the UK are predicted to rise from 2.5 million in 2015 to four million by 2030 – with an annual cost to the UK economy that currently exceeds £15bn. With so much at stake, we at Patients Campaigning For Cures, welcome the call for rigorous scientific Debate, with growing support at Westminster from over a hundred cross-party MPs (representing seven million UK constituents).

What is outdated and failing medical research?

The majority of research funds are still directed towards animal models of human patients – despite animals now shown to be entirely failing as predictive models of human response to drugs and disease.

Current medical understanding explains why we need to stop funding outdated Victorian principles that ignore critical complex species differences, and to redirect valuable finance towards human-based research, which has a proven track record of success.

Current science shows us how to succeed

Thanks to the scientific breakthroughs made in the early 2000s by the Human Genome Project, we now understand that men and women can respond very differently to drugs and disease, as do different ethnic groups. And we know that identical twins do not always suffer from the same diseases, or react in the same way to a drug, because of very small differences in their genetic makeups. All of which is explained by advances in our knowledge of evolutionary biology and genetics.

The genome project advanced our understanding that the process of evolution does not consist solely of adding new genes to make a new species. Together with other similar achievements, the project informed us that individual humans differ from each other for many of the same reasons that species differ from each other. For example, the same gene can be turned off in one individual but turned on (expressed) in another. During development, mice have turned on the gene that allows them to grow a tail, while humans usually have it turned off. Changes like this can lead to new species – or predispose one individual to a disease while another does not suffer from that illness.

The Human Genome Project also explained that differences between a human and a rat, dog, or monkey are much greater than the differences amongst humans. Very small differences in the genetic makeup between species mean that what happens when a monkey is infected with HIV is very different from what happens when humans are infected. This also explains why medicines that are safe and effective in mice kill or maim humans – and vice versa. Humans can share 99 per cent of their genetic makeup with another species and yet still demonstrate profound differences in terms of responses to drugs and disease. With 90 per cent of drugs that looked promising in animals failing at the human clinical trial stage, pharmaceutical companies openly and often acknowledge the very costly lack of predictive value animal models have in their drug development process.

Personalized medicine means matching the correct drug to the patient in order to maximize efficacy while minimizing side effects. There are now over 100 medicines linked to specific genes, and patients can be tested for those genes before being given those drugs. Cancer therapies can be based on a patient’s genome instead of a one-size-fits-all solution. Studies in humans have shown that children with certain genes require more medicine for post-operative pain control. Many diseases are now treated based on such unique genetic information. All of this is in stark contrast to testing on completely different species.

Today there is a rapid growth in innovative human-relevant research models, harnessing a range of contemporary digital and biotechnologies, collectively known as Non-Animal Technologies (NATs). Innovate UK has identified NATs as emerging science that could help drive future UK economic growth, with the global market expected to be worth billions. Redirecting funding towards human-based medical research is a win-win for individual patients and society as a whole.

The first step towards vital medical research reform is to settle the science publicly – and what better way than to hold the sequel to the Huxley-Wilberforce debate? We propose Great Debate Two: between Dr. Ray Greek, the leading expert against animal models of human responses to drugs and disease – who has already agreed to participate – and the neurobiologist and noted proponent of animal-based research, Professor Colin Blakemore.

We therefore welcome this Open Letter to Professor Blakemore, and hope that he will respond positively.

Open letter:

Professor Colin Blakemore, 

 

A freedom of information request provided your letter to the Planning Inspectorate, recommending the extension of a Beagle Breeding Farm at B&K Universal in Grimston Hull. The farm will purpose breed around 2,000 dogs annually, destined for painful and traumatic laboratory experiments - typically involving dogs being force-fed chemicals in experiments lasting 90 days with no pain relief or anaesthetic. According to current medical knowledge the results of such experiments are not capable of predicting the responses of human patients, a position highlighted by The British Medical Journal in its Editor’s Choice, June 2014.

 

Over 100 MPs, to date, have signed Parliamentary EDMs to hear this evidence in a public scientific debate, overseen by independent judges from the relevant fields of scientific expertise. In your letter, you claim to have “always tried to engage with those who oppose animal research and take proper account of their objections”, and that it is “unacceptable” that research “is impeded or prevented by extreme action”. We therefore call upon you to agree to participate in the thorough scientific debate, as called for by the Parliamentary EDMs and their growing support. 

 

Yours sincerely,

 

Ricky Gervais

Chris Packham

Peter Egan 

Dr Jane Goodall DBE

Jane Fallon

Lesley Nicol

Jill Robinson MBE

Rumer

Rick Wakeman

 

This Open Letter will remain active at www.forlifeonearth.org, where further public figures can sign it.

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Labour’s renationalisation plans look nothing like the 1970s

The Corbynistas are examining models such as Robin Hood Energy in Nottingham, Oldham credit union and John Lewis. 

A community energy company in Nottingham, a credit union in Oldham and, yes, Britain's most popular purveyor of wine coolers. No, this is not another diatribe about about consumer rip-offs. Quite the opposite – this esoteric range of innovative companies represent just a few of those which have come to the attention of the Labour leadership as they plot how to turn the abstract of one of their most popular ideas into a living, neo-liberal-shattering reality.

I am talking about nationalisation – or, more broadly, public ownership, which was the subject of a special conference this month staged by a Labour Party which has pledged to take back control of energy, water, rail and mail.

The form of nationalisation being talked about today at the top of the Labour Party looks very different to the model of state-owned and state-run services that existed in the 1970s, and the accompanying memories of delayed trains, leaves on the line and British rail fruitcake that was as hard as stone.

In John McDonnell and Jeremy Corbyn’s conference on "alternative models of ownership", the three firms mentioned were Robin Hood Energy in Nottingham, Oldham credit union and, of course, John Lewis. Each represents a different model of public ownership – as, of course, does the straightforward takeover of the East Coast rail line by the Labour government when National Express handed back the franchise in 2009.

Robin Hood is the first not-for-profit energy company set up a by a local authority in 70 years. It was created by Nottingham city council and counts Corbyn himself among its customers. It embodies the "municipal socialism" which innovative local politicians are delivering in an age of austerity and its tariffs delivers annual bills of £1,000 or slightly less for a typical household.

Credit unions share many of the values of community companies, even though they operate in a different manner, and are owned entirely by their customers, who are all members. The credit union model has been championed by Labour MPs for decades. 

Since the financial crisis, credit unions have worked with local authorities, and their supporters see them as ethical alternatives to the scourge of payday loans. The Oldham credit union, highlighted by McDonnell in a speech to councillors in 2016, offers loans from £50 upwards, no set-up costs and typically charges interest of around £75 on a £250 loan repaid over 18 months.

Credit unions have been transformed from what was once seen as a "poor man's bank" to serious and tech-savvy lenders where profits are still returned to customers as dividends.

Then there is John Lewis. The "never-knowingly undersold" department store is owned by its 84,000 staff, or "partners". The Tories have long cooed over its pledge to be a "successful business powered by its people and principles" while Labour approves of its policy of doling out bonuses to ordinary staff, rather than just those at the top. Last year John Lewis awarded a partnership bonus of £89.4m to its staff, which trade website Employee Benefits judged as worth more than three weeks' pay per person (although still less than previous top-ups).

To those of us on the left, it is a painful irony that when John Lewis finally made an entry into politics himself – in the shape of former managing director Andy Street – it was to seize the Birmingham mayoralty ahead of Labour's Sion Simon last year. (John Lewis the company remains apolitical.)

Another model attracting interest is Transport for London, currently controlled by Labour mayor Sadiq Khan. TfL may be a unique structure, but nevertheless trains feature heavily in the thinking of shadow ministers, whether Corbynista or soft left. They know that rail represents their best chance of quick nationalisation with public support, and have begun to spell out how it could be delivered.

Yes, the rhetoric is blunt, promising to take back control of our lines, but the plan is far more gradual. Rather than risk the cost and litigation of passing a law to cancel existing franchises, Labour would ask the Department for Transport to simply bring routes back in-house as each of the private sector deals expires over the next decade.

If Corbyn were to be a single-term prime minister, then a public-owned rail system would be one of the legacies he craves.

His scathing verdict on the health of privatised industries is well known but this month he put the case for the opposite when he addressed the Conference on Alternative Models of Ownership. Profits extracted from public services have been used to "line the pockets of shareholders" he declared. Services are better run when they are controlled by customers and workers, he added. "It is those people not share price speculators who are the real experts."

It is telling, however, that Labour's radical election manifesto did not mention nationalisation once. The phrase "public ownership" is used 10 times though. Perhaps it is a sign that while the leadership may have dumped New Labour "spin", it is not averse to softening its rhetoric when necessary.

So don't look to the past when considering what nationalisation and taking back control of public services might mean if Corbyn made it to Downing Street. The economic models of the 1970s are no more likely to make a comeback then the culinary trends for Blue Nun and creme brûlée.

Instead, if you want to know what public ownership might look like, then cast your gaze to Nottingham, Oldham and dozens more community companies around our country.

Peter Edwards was press secretary to a shadow chancellor, editor of LabourList and a parliamentary candidate in 2015 and 2017.